APPEALS PROCESS

You can appeal most determinations and decisions we make about whether you can get Supplemental Security Income (SSI) or if we make changes to your benefit amount. That means you can ask us to look at your case again.

When you ask for an appeal, we will look at the entire determination or decision, even those parts that were in your favor.

HOW TO APPEAL SOCIAL SECURITY DETERMINATIONS AND DECISIONS

We have established appeals procedures for individuals who disagree with the determination(s) or decision(s) we make. The determination(s) or decision(s) that you can appeal are called "initial determinations" and we discuss them further below. The levels of appeal are:

Reconsideration (for disability claims available in most States);

Administrative Law Judge Hearing;

Appeals Council Review;

Federal Court.

INITIAL DETERMINATION

We call the determinations we make that you can be appeal "initial determinations." These determinations include but are not limited to:

whether or not you are eligible;

the amount of your SSI payment; and

the fact that you were overpaid and the amount of the overpayment and whether you must repay it.

After you file an application for SSI, we will mail you a written determination. This is your first "initial determination", but each time we made a determination about your eligibility or payment amount after that is also an initial determination.

When we make an initial determination, we send you a notice. If you want to appeal the initial determination in that notice, you must request an appeal in writing within 60 days of the date you receive your notice. The notice will tell you how to appeal. If you file an appeal within 10 days, your SSI benefits may continue at the same amount until we make a determination on your appeal.

The notice will tell you if you are entitled to continued benefits.

Contact us, and we can help you with your appeal.

You may appoint a representative to act for you in the Social Scurity appeals process. For information on how to appoint a representative, see "How Someone Can Help You With Your SSI".

STEPS IN THE APPEALS PROCESS

1. RECONSIDERATION

If you disagree with the initial determination, you may request reconsideration by writing to us or by
completing:Form SSA–561 (Request for Reconsideration); or,Form SSA–789 (Request for Reconsideration - Disability Cessation).

You or your representative must ask in writing for reconsideration within 60 days of the date you receive the written notice of the initial determination. We consider that you receive a notice 5 days after the date on the notice. If you ask for reconsideration in writing within 10 days, any payment we are currently making will continue until we make our determination, if you continue to meet all other SSI eligibility requirements.

We will send you (and your representative, if you have one) a notice of the reconsideration determination.

If you appeal a disability cessation and you want to keep receiving benefits until we make a determination, you must make a written request for benefit continuation within 10 days after the date you receive the written notice. You are entitled to a face-to-face hearing with a disability hearing officer.

In certain States, we are using a revised appeals process, which may replace the steps here. If you are in one of these States, the notice of our determination will give you specific instructions about how to appeal.

2. HEARING

If you disagree with the reconsideration determination, you or your representative may request a hearing before an administrative law judge (ALJ) by writing to us or by completing a
Form HA–501 (Request for Hearing).
A request for a hearing on a disability claim can be completed online at: www.socialsecurity.gov. If needed, we can help you complete this form.

You or your representative must request a hearing within 60 days after you get the notice of reconsideration determination (or, in certain States, the initial determination).
We consider that you receive the notice 5 days after the date on the notice. You or your representative may review your file before the hearing and may submit new evidence.
You may continue to receive your SSI if you are appealing a determination that your disability has ended. You must ask in writing for your benefits to continue.

If you do not want to appear in person at a hearing before an ALJ, you or your representative may ask the ALJ to make a decision
based on the evidence in your file.

If you do want to have a hearing before an ALJ, it is very important that you or your representative appear either
in person by video teleconferencing, or by telephone (in extraordinary circumstances) at the scheduled hearing. If for any reason you cannot make it, contact the ALJ as soon as possible
before the hearing and explain why. If you do not attend the scheduled hearing, you may lose your appeal rights
and benefits.

We may pay you for travel costs if the distance to the hearing from your home is more than 75 miles one way.
If you need money for travel costs, tell the ALJ as soon as possible before the hearing.

In a disability case, the ALJ may also want you to have more medical exams or tests. We will pay for any exam or test that we require and schedule for you.

The ALJ may ask other witnesses, such as medical experts to come to the hearing. You may ask the ALJ
to order certain witnesses to attend the hearing.

During the hearing, the ALJ will explain your case and may ask you and any of your witnesses questions.
You may also ask any witnesses questions and present new evidence.

The hearing is informal, but we record it. You may ask for a copy of
the hearing recording.

The ALJ will send you (and your representative, if you have one) a copy of the hearing decision.

3. APPEALS COUNCIL

If you disagree with the ALJ's decision, you (or your representative) may request
an appeal by writing to us and requesting an Appeals Council review or by completing
a Form HA–520 (Request for Review of Hearing Decision/Order). We can help you
complete this form.

You (or your representative) must ask for an Appeals Council review
within 60 days after you get the hearing decision. We consider that you receive the hearing decision 5 days after the date on the hearing decision.

You or your representative may submit new evidence. The Appeals Council will examine your case and will grant, deny, or dismiss your request for review.
If the Appeals Council grants your request for review, it will either decide your case or return it to the ALJ for
further action, which could include another hearing and a new decision.

The Appeals Council will send you (and your representative) a copy of the action it takes on your request for review and explain the reasons for this action.

4. FEDERAL COURT

If the Appeals Council issues a decision or denies your request for review of an ALJ’s decision and you disagree with the action of the Appeals Council, you may file a civil action with the U.S. District Court in your area. We cannot help you file a court action. You may want to contact a lawyer or a legal aid group to help you.

You must file an action in U.S. District Court within 60 days after you receive the notice of Appeals Council action. We consider that you receive notice of the Appeals Council action 5 days after the date on the notice.

The U.S. District Court will review the evidence and the final Agency decision.

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